{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T06:51:00Z","timestamp":1791442260050,"version":"4.3.3"},"reference-count":20,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pathology International"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Pleural mesothelioma is an aggressive tumor with a poor prognosis and limited therapeutic options. While histological heterogeneity is common, true squamous differentiation is extremely rare and diagnostically challenging. We report an 81\u2010year\u2010old man with asbestos exposure who presented with recurrent right\u2010sided pleural effusion. Thoracoscopic biopsies revealed two distinct tumor components. The first expressed mesothelial immunohistochemical markers, whereas the second showed a squamous profile. Both components demonstrated loss of BAP1 expression and homozygous deletion of CDKN2A, supporting a common mesothelial origin. Whole\u2010exome sequencing revealed a tumor mutational burden above the average reported for mesothelioma (8\u20139 mutations per megabase), with 69 somatic mutations in total, 43 shared between the two components. In addition to canonical mesothelioma alterations (BAP1, CHEK2), the squamous component harbored 18 unique variants, including oncogenic alterations in NFE2L2 and PIK3CA. A novel SOX9 missense variant of uncertain significance (p. Thr243Pro) was also identified within the transactivation middle (TAM) domain; its functional consequence remains unknown. This case highlights a rare histological variant of pleural mesothelioma with partially squamous differentiation, characterized by a mutational burden above the mesothelioma average and squamous carcinoma\u2010associated alterations. Integrated histology, immunohistochemistry, and genomic profiling are essential to avoid misdiagnosis and to improve understanding of tumor plasticity in mesothelioma.<\/jats:p>","DOI":"10.1111\/pin.70190","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T06:12:26Z","timestamp":1791439946000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pleural Mesothelioma With Unusual Squamous Differentiation: A Clinicopathological Case Report With Molecular Insights From Whole\u2010Exome Sequencing"],"prefix":"10.1111","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9937-1837","authenticated-orcid":false,"given":"Julius","family":"Bodemeyer","sequence":"first","affiliation":[{"name":"Institute of Pathology University Medical Center G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mara Elisa","family":"Mierzwa","sequence":"additional","affiliation":[{"name":"Institute of Pathology University Medical Center G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Seraphin","sequence":"additional","affiliation":[{"name":"Medical Care Center Onkologikum Northeim Northeim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rizkallah","family":"Maroun","sequence":"additional","affiliation":[{"name":"Medical Care Center Onkologikum Northeim Northeim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang","family":"K\u00f6rber","sequence":"additional","affiliation":[{"name":"Department for Pneumology Evangelical Hospital G\u00f6ttingen\u2010Weende G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Engelke","sequence":"additional","affiliation":[{"name":"Department for Radiology Evangelical Hospital G\u00f6ttingen\u2010Weende G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0367-6527","authenticated-orcid":false,"given":"Felix","family":"Bremmer","sequence":"additional","affiliation":[{"name":"Institute of Pathology University Medical Center G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tessa","family":"Rosenthal","sequence":"additional","affiliation":[{"name":"Institute of Pathology University Medical Center G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Hei\u00dfenberg","sequence":"additional","affiliation":[{"name":"Department of Pathology and Molecular Pathology University Hospital Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten","family":"Reuter\u2010Jessen","sequence":"additional","affiliation":[{"name":"Institute of Pathology University Medical Center G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8528-8060","authenticated-orcid":false,"given":"Philipp","family":"Str\u00f6bel","sequence":"additional","affiliation":[{"name":"Institute of Pathology University Medical Center G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Marx","sequence":"additional","affiliation":[{"name":"Institute of Pathology University Medical Center G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1038-1030","authenticated-orcid":false,"given":"Hanibal","family":"Bohnenberger","sequence":"additional","affiliation":[{"name":"Institute of Pathology University Medical Center G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00292-017-0364-z"},{"key":"e_1_2_12_4_1","series-title":"WHO Classification of Tumours Series","volume-title":"WHO Classification of Tumours: Thoracic Tumours, 5th ed., vol. 3","author":"Sauter J. L.","year":"2021"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCO.0000000000000053"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2017-0124-RA"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2019.02.004"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2303.1993.tb00117.x"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.13482"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.24686"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/pin.13143"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pathol.2016.03.005"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/ng.3520"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41416-022-01979-0"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.25109"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep14237"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccell.2016.04.004"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41416-025-03113-2"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/15384101.2015.1053669"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gendis.2014.09.004"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.27925"}],"container-title":["Pathology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pin.70190","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/pin.70190","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pin.70190","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T06:12:27Z","timestamp":1791439947000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pin.70190"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":20,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/pin.70190"],"URL":"https:\/\/doi.org\/10.1111\/pin.70190","archive":["Portico"],"relation":{},"ISSN":["1320-5463","1440-1827"],"issn-type":[{"value":"1320-5463","type":"print"},{"value":"1440-1827","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-03-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70190"}}